Tag: ohio medical board

Disciplinary Action, Medical Board, Medical practice in Ohio, physicians, reporting, Uncategorized

Physicians: Pay Attention to Supervision Agreements

A supervision agreement must provide that the physician agrees to supervise the physician assistant and the physician assistant agrees to practice under that physician’s supervision.

A supervision agreement must provide that the supervising physician is legally responsible and assumes legal liability for the services provided by the physician assistant.

A supervision agreement must be signed by the physician and the physician assistant.

a. If a physician assistant will practice within a health care facility, the supervision agreement must include terms that require the physician assistant to practice in accordance with the policies of the health care facility; and/or

Medical practice in Ohio, Notice of Opportunity for Hearing, Respond to Board Letters, State Medical Board of Ohio

Ohio Physicians: Timely open and respond to all letters from the Medical Board

Keep your address up to date

As a physician licensed to practice medicine in Ohio, you are required (under R.C. 4731.281) to maintain your current accurate mailing address with the State Medical Board of Ohio. You may update your address online at: http://med.ohio.gov/UpdateAddress.aspx

The address on file with the Medical Board will be the official address that the Board will use to contact a physician if they become the subject of an investigation, or if the Board proposes to take a disciplinary action against a physician.

Certified Mail

If the Medical Board takes an action against a physician, they will be mailed a letter outlining the charges to their address of record with the Board. Under RC 119.07, the Notice of a Board Order shall be given by registered mail, return receipt requested, and shall include the charges or other reasons for the proposed action, the law or rule directly involved, and a statement informing that the party is entitled to a hearing if the party requests it within thirty days of the time of mailing the notice.

If you receive a certified mail from the Medical Board, it is imperative that you open it!  If the Medical Board has mailed a certified letter to a physician, it will include important information and often requires an action to be taken by the physician within a short period of time.

For example, if the Medical Board issues a Notice of Opportunity for Hearing to a physician, the physician is only provided with 30 days (from the date of mailing by the Board) to request a hearing. Failure to timely request a hearing may result in a board-ordered sanction, and the physician would be provided with no means to defend their case. The sanction takes the form of a Final Adjudication Order under RC 119.

Failure to cooperate in an Investigation

Failing to respond to a subpoena request or to respond to Interrogatory questions sent from the Medical Board may also result in a disciplinary action taken against the physician by the Medical Board. R.C. 4731.22(34) provides that failure to cooperate in an investigation conducted by the Board, including failure to answer a subpoena or order issued by the Board, or failure to answer truthfully a question presented by the Board in an investigative interview, an investigative office conference, at a deposition, or in written interrogatories, will result in disciplinary action.

Publication notification

If you fail to accept delivery of certain notifications, the Medical Board has the authority to publish the notification in your local newspaper. If any notice sent is returned for failure of delivery, the agency either shall make personal delivery of the notice by an employee or the agent shall publish the notice once a week for three consecutive weeks in a newspaper of general circulation in the county where the last known address of the party is located. When notice is given by publication, a proof of publication affidavit, with the first publication of the notice set forth in the affidavit, shall be mailed by ordinary mail to the party at the party’s last known address and the notice shall be deemed received as of the date of the last publication.

Refusal of delivery by personal service or mail is not failure to deliver and service is still deemed to be complete. Therefore, it is important to keep your address up to date in order to accept all certified mail that is sent from the Medical Board. Be sure to carefully review all letters from the Board as they often include short timelines in which a response may be required.

If you have any questions about this post or the State Medical Board of Ohio, please feel free to contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email me at Beth@collislaw.com.

State Medical Board of Ohio, Uncategorized

Ohio Medical Board to Impose Monetary Fines

The State Medical Board of Ohio is authorized to impose a range of sanctions against a physician for violating the Board’s laws and rules. The sanctions range from a reprimand to suspension, limitation, revocation or permanent revocation of a medical license. R.C. 4731.22(B)(22).  http://codes.ohio.gov/orc/4731.22v1.  However, for actions that arise AFTER September 29, 2015, in addition to imposing one of the sanctions listed above, the Medical Board is also authorized to impose a monetary fine against a physician for violating the Board’s laws or rules.

The chart listing the range of monetary fines can be found on the Medical Board’s website at: http://www.med.ohio.gov/Portals/0/DNN/PDF-FOLDERS/For-The-Public/FiningGuidelinesIncludingCivilPenalties.pdf.

The monetary fines imposed by the Medical Board are steep. It would be expected that the sanction for being convicted of a felony or crime involved in the practice of medicine would result in a substantial fine; however, even in cases that may appear less egregious the Medical Board is authorized to impose substantial monetary fines. For example:

  • prescribing a controlled substance to self or a family member in violation of OAC 4731-11-08, the Medical Board may impose a fine ranging from $3,000-$10,000, with the “standard fine” being $4,500.00;
  • willfully betraying a professional confidence, the Medical Board may impose a fine ranging from $5,000-$20,000, with the “standard fine” being $9,500.00;
  • supervising a physician assistant, anesthesiology assistant, or radiology assistant without a supervisory plan and approved supervisory agreement may result in a monetary fine ranging from $5,000-$20,000, with the “standard fine” being $9,000.

In addition, the Board Members have made it clear that inability to pay a monetary fine is not a defense. The Medical Board will not look at a licensee’s ability to pay prior to imposing a monetary fine.

As a licensed physician in Ohio, you should be familiar with the Medical Board’s laws and rules which can be found at the Medical Board’s website at: http://www.med.ohio.gov/.  You should also be familiar with the Board’s disciplinary authority.

As always, if you have any questions about this post or about the State Medical Board of Ohio in general, feel free to contact me at beth@collislaw.com or call me at 614-486-3909.

State Medical Board of Ohio, Uncategorized

The Ohio Medical Board’s “slip rule” and when to contact the Ohio Medical Board if you relapse

Happy New Year!

I am often asked what Ohio physicians who are under probation with the Ohio Medical Board should do, if they relapse on drugs and/or alcohol or if they believe they have inadvertently been exposed to alcohol or a drug that may cause impairment.

If you are licensed to practice medicine in the State of Ohio, the Ohio Medical Board may take an action against your professional license if it has reason to believe that you are impaired in your ability to practice medicine (OAC 4731-16-01).  In such event, typically, a physician will enter into a Step I Consent Agreement with the Ohio Medical Board in which the physician’s medical license is suspended while they seek treatment for substance or alcohol abuse or addiction.

Once the physician has completed treatment and the Ohio Medical Board determines they are fit to resume practice,  the physician will be offered a Step II Consent Agreement, which reinstates the physician’s medical license subject to probationary terms.  Once a physician’s license is reinstated, they are generally placed on probation for five years. During probation, they are typically required to maintain abstinence, submit to random drug and/or alcohol testing, complete aftercare treatment, attend AA (12 Step) meetings, and complete other monitoring conditions.

During probation, the physician is not permitted to consume any alcohol and/or ingest drugs (except as prescribed).  The physician will be subjected to random alcohol and/or drug testing that is highly sensitive and can detect even incidental exposure.

What should the physician who is under probation with the Ohio Medical Board do if they consume alcohol or a drug to which they have not been prescribed or  believe they have been inadvertently exposed to these substances? 

A relapse is defined in Ohio Administrative Code 4731-16-01(B) as follows:

“Relapse” means any use of, or obtaining for the purpose of using, alcohol or a drug or substance that may impair ability to practice, by someone who has received a diagnosis of and treatment for chemical dependency or abuse, except pursuant to the directions of a treating physician who has knowledge of the patient’s history and of the disease of addiction, or pursuant to the direction of a physician in a medical emergency. An instance of use that occurs during detoxification treatment or inpatient or residential treatment before a practitioner’s disease of addiction has been brought into remission does not constitute a relapse.”

If a physician relapses on alcohol or a drug to which they have not been prescribed, the Ohio Medical Board may take further action against their professional license, including but not limited to suspending their license and/or requiring them to seek additional treatment.  However, if the physician is experiencing a first time relapse by consuming alcohol (or a drug) for less than one day, the Ohio Medical Board may determine that it will not take further action, if the physician immediately seeks treatment, self reports to the Ohio Medical Board within 48 hours of the relapse and follows all other requirements of OAC 4731-16-02(D).

OAC 4731-16-02, commonly known at the “slip-rule”, may prevent a physician from having their Ohio medical license suspended or being subjected to further discipline by the Ohio Medical Board in the event of a relapse. However, the physician must meet all of the requirements of the rule.  If you are a physician who is subject to monitoring by the Ohio Medical Board for alcohol or drug addiction or abuse, you should be familiar with the requirements of OAC 4731-16. http://codes.ohio.gov/oac/4731-16

As always, if you have any questions about this post or about the State Medical Board of Ohio in general, please feel free to contact one of the attorneys at the Collis Law Group LLC at 614-486-3909 or email me at beth@collislaw.com.

State Medical Board of Ohio

Ohio Courts will not reverse Medical Board decisions if the sanction seems too harsh

I recently read of a Medical Board disciplinary matter in the State of Illinois, in which the Illinois Medical Board revoked a physician’s medical license for engaging in a sexual relationship with a patient. Then, the Illinois Appeals court reversed the decision and sent the case back to the Illinois Board to issue an alternative sanction after finding the sanction was “overly severe” given the physician’s conduct. William Joel Kafin v. The Division of Professional Regulation of the Department of Financial and Professional Regulation.   I was struck by this case, as this would never happen in Ohio.

In Ohio, under Ohio Revised Code Chapter 119, decisions of the State Medical Board can be appealed to the Franklin County Courts. The Court will then determine if the decision of the Board was based on reliable, probative and substantial evidence and is in accordance with law. Pons v. Ohio St. Med. Bd., 66 Ohio St.3rd 619, 621. However, case-law exists in Ohio that the Courts will not reverse a decision of the Medical Board purely on the belief that the sanction is too harsh. Henry’s Cafe, Inc. v. Bd. of Liquor Control, (1950), 170 Ohio St.233. Even if the evidence is clear that the Ohio Medical Board imposed a sanction that was different or harsher than was imposed in other similarly situated cases, the Courts still not reverse a Medical Board decision.

The only way to obtain relief from a Medical Board decision by the Courts is to show that the Board based its decision on evidence that was contrary to law or was not reliable, probative or substantial. While it is not unheard of to have a Medical Board decision reversed by the Court, it is certainly an uphill battle.

It is the intent of Ohio administrative procedure law that state agencies be given the authority to regulate others in their profession. Arlen v. State Med. Bd (1980), 61 Ohio St.2d 168. Therefore, if a physician is issued a Notice of Opportunity for Hearing (citation letter), it is important to put your best case forward at the administrative hearing before the Medical Board.  The Court will rarely disturb the final decision of the Medical Board.  Unlike Illinois, Ohio courts will not reverse a Medical Board decision because the Court thinks the sanction is too harsh.

As always, if you have any questions about this post or the State Medical Board of Ohio in general, please feel free to email me at beth@collislaw.com or call me at (614) 486-3909 or see our firm website at www.collislaw.com.